Certain neurostimulation procedures require the placement of electrodes via abdominal access. For example, US Patent Appl. Publ. No. 2005/0021102 describes a system and method for stimulating a conditioning a diaphragm through electrical stimulation of target sites on the diaphragm. The electrodes may be implanted laparoscopically, using, e.g., an electrode delivery instruments such as those described in U.S. Pat. Nos. 5,797,923 and 5,472,438.
It is often desirable to electrically map possible stimulation electrode sites to find the most appropriate target site for implanting the stimulation electrode(s). An example of a mapping probe system for use with neuromuscular stimulation systems is described in US Patent Appl. Publ. No. 2005/0107860. This mapping probe is designed to be inserted laparoscopically through a cannula that has been placed in the patient's peritoneal cavity through an incision in the patient's abdominal wall.
While less invasive than open surgery, laparoscopic delivery of mapping and/or stimulation electrodes still requires the surgeon to make multiple incisions through the patient's skin to access to the patient's abdomen for the visualization and electrode manipulation instruments. In addition, access to certain sites within and around the abdomen may be difficult, depending on the location of the laparoscopic port with respect to the target sites. While transesophageal approaches to cardiovascular and mediastinal procedures have been proposed (see, e.g., US Patent Appl. Publ. No. 2005/0148818), and while transgastric peritoneal cavity access tools have been described (see, e.g., U.S. Pat. No. 6,918,871; US Patent Appl. Publ. No. 2004/0260245; US Patent Appl. Publ. No. 2005/0277945; and US Patent Appl. Publ. No. 2001/0049497), the prior art has not addressed transgastric neuro-mapping and neurostimulation procedures in the peritoneal cavity. What is needed, therefore, are methods and devices for delivering mapping and/or stimulation electrodes to their target sites in and around the abdomen. In particular, what is needed is a better way to removably deliver mapping electrodes to multiple tissue sites within and around the peritoneal cavity.